Provider Demographics
NPI:1932700812
Name:MADDOX, DANIEL A (LPC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:MADDOX
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CREEKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3272
Mailing Address - Country:US
Mailing Address - Phone:205-928-2515
Mailing Address - Fax:
Practice Address - Street 1:100 CREEKWOOD LN
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-3272
Practice Address - Country:US
Practice Address - Phone:205-928-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4461103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling